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. 2022 Oct 4;14(4):38651.
doi: 10.52965/001c.38651. eCollection 2022.

A Review of Current Concepts of the Anterolateral Complex of the Knee

Vasileios Athanasiou  1 , Andreas Panagopoulos  1 , Antonios Kouzelis  1 , Zinon T Kokkalis  1 , John Lakoumentas  2 , Konstantinos Katsanos  3 , John Gliatis  1
Affiliations

A Review of Current Concepts of the Anterolateral Complex of the Knee

Vasileios Athanasiou et al. Orthop Rev (Pavia). .

Abstract

The anterolateral complex (ALC) of the knee has gained increased interest over the last decades due to the high revision rates of anterior cruciate ligament reconstruction (ACLR). Furthermore, in patients with an ACL tear, the injury of at least one of the ALC's anatomic structures has been shown to be significantly higher, thus affecting its secondary stabilizing role at the knee joint. As such, ACLR augmentation techniques, that embrace the ALC, have been proposed recently, and indications for these procedures are still evolving. This review aims to present and discuss the most current anatomical, biomechanical, and imaging data, current reconstruction techniques, and the clinical results of ALC reconstruction.

Keywords: “Anterior cruciate ligament”; “Anterolateral complex of the knee”; “Anterolateral ligament reconstruction”; “Anterolateral ligament”; “Lateral extra-articular tenodesis”.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.. Anterolateral complex of the knee.
ALL = anterolateral ligament; FCL = fibular collateral ligament; GT = lateral gastrocnemius tendon; ITB = iliotibial band; LE = lateral epicondyle; PLT = popliteus tendon
Figure 2.
Figure 2.. Shows a combination of ALC injury with bone edema.
The row in a-1,2, b-1,2, c-1,2 indicates an ALL tear (From the authors’ archive).
Figure 3.
Figure 3.. Modified Lemaire procedure.
A, B, Landmarks of surgical approach, lateral epicondyle, gerdy’s tubercle and fibular head; C, D, Surgical approach and harvesting 1cm width of the fascia lata; E, D, Fascia lata strip preparation and fixation (Linndsay et al, Arthroscopy TechniquesVolume 9, Issue 1, January 2020, Pages e111-e116).
Figure 4.
Figure 4.. Combined ACL/ALL reconstruction.
Anterolateral ligament reconstruction using gracilis graft. A, B, C, Tunnel preparation, check isometry; D, E, F, Gracillis graft passing under the fascia and fixation (Combined ACL and Anterolateral Ligament Reconstruction. B. Saithna A, et al. JBJS Essent Surg Tech. 2018 Jan 10;8(1):e2.)
See this image and copyright information in PMC

References

    1. 1. Kim SH. Editorial Commentary: Knee Anterolateral Ligament Cadaveric, Biomechanical Analysis Should Include Tensioning of All Knee Dynamic Structures. Arthroscopy. 2021;37(4):1192-1193. doi:10.1016/j.arthro.2020.12.229 - PubMed
    1. 2. Santoso A, Anwar IB, Sibarani T, et al. Research on the Anterolateral Ligament of the Knee: An Evaluation of PubMed Articles From 2010 to 2019. Orthop J Sports Med. 2020;8(12):232596712097364. doi:10.1177/2325967120973645 - PMC - PubMed
    1. 3. Littlefield CP, Belk JW, Houck DA, et al. The Anterolateral Ligament of the Knee: An Updated Systematic Review of Anatomy, Biomechanics, and Clinical Outcomes. Arthroscopy. 2021;37(5):1654-1666. doi:10.1016/j.arthro.2020.12.190 - PubMed
    1. 4. Musahl V, Rahnemai-Azar AA, van Eck CF, Guenther D, Fu FH. Anterolateral ligament of the knee, fact or fiction? Knee Surg Sports Traumatol Arthrosc. 2016;24(1):2-3. doi:10.1007/s00167-015-3913-0 - PubMed
    1. 5. Lau BC, Rames J, Belay E, Riboh JC, Amendola A, Lassiter T. Anterolateral Complex Reconstruction Augmentation of Anterior Cruciate Ligament Reconstruction: Biomechanics, Indications, Techniques, and Clinical Outcomes. JBJS Rev. 2019;7(11):e5. doi:10.2106/jbjs.rvw.19.00011 - PubMed